scholarly journals Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 893-894
Author(s):  
Hyunjin Noh ◽  
Cho Rong Won ◽  
Zainab Suntai
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Family Caregivers ◽  
Rural Areas ◽  
Pain Treatment ◽  
Financial Burden ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Thinking Skills ◽  
Rural Older Adults

Abstract Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.

scholarly journals Rural Older Adults’ Experiences With Pain From Chronic Illnesses and Its Treatment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 290-291
Author(s):  
Hyunjin Noh ◽  
Zainab Suntai ◽  
Cho Rong Won
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pain Treatment ◽  
Insurance Coverage ◽  
Local Area ◽  
Health Insurance Coverage ◽  
Thinking Skills ◽  
Structured Interviews ◽  
Rural Older Adults

Abstract Although pain control is an essential factor in promoting quality of life, pain is undertreated among certain sub-populations, such as older adults and rural residents. The purpose of this study was to explore pain experiences and its treatment among rural older adults. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 55+, have good thinking skills, resident of Alabama, have chronic/serious health conditions, and experienced pain or discomfort in the last 3 months. Twenty-three participants were recruited from rural counties of West and South Alabama through the local Area Agency on Aging and health and senior service centers. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Thematic analysis was conducted to identify emerging themes and repeated patterns from the data. Our results revealed themes in four categories: 1) impact of pain: physical limitations and coping strategies, 2) Impact of Covid-19: physical health, social, and mental health impact, 3) challenges in pain treatment: transportation (driver/time/cost/Covid-19 exposure) and non-transportation related problems (lacking resources/mistrust/limited health insurance coverage), and 4) suggestions: transportation-related (more transportation options/financial assistance) and non-transportation-related support (improved insurance coverage/non-pharmacological care) . Findings of this study highlight rural older adults’ unique needs in access to pain treatment, further amplified during the Covid-19 pandemic. Increase in sustainable, funded transportation programs and the supply of local pain specialists is critical to meet such needs and improve their quality of life.

Autism and Families' Financial Burden: The Association With Health Insurance Coverage

2015 ◽  
Vol 120 (2) ◽  
pp. 166-175 ◽  
Author(s):  
Susan L. Parish ◽  
Kathleen C. Thomas ◽  
Christianna S. Williams ◽  
Morgan K. Crossman
Keyword(s):  
Health Insurance ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Autism Spectrum ◽  
Medical Expenditure ◽  
Outpatient Services ◽  
Raising Children

Abstract We examined the relationship between family financial burden and children's health insurance coverage in families (n  =  316) raising children with autism spectrum disorders (ASD), using pooled 2000–2009 Medical Expenditure Panel Survey data. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families' income. Families spent an average of $9.70 per $1,000 of income on their child's health care costs. Families raising children with private insurance were more than 5 times as likely to have any out-of-pocket spending compared to publicly insured children. The most common out-of-pocket expenditure types were medications, outpatient services, and dental care. This study provides evidence of the relative inadequacy of private insurance in meeting the needs of children with ASD.

scholarly journals New Insights on Self-Employment of Older Adults in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 460-460
Author(s):  
Joelle Abramowitz
Keyword(s):  
United States ◽  
Older Adults ◽  
Health Insurance ◽  
Home Ownership ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Administrative Records ◽  
Self Employment ◽  
Different Types

Abstract This work examines the nature of self-employment arrangements of older adults in the United States. Many people engage in self-employment - in the 2016 Health and Retirement Study (HRS), 20 percent of respondents working for pay reported being self-employed - yet there exists a dearth of data on these arrangements. This lack of data prevents consideration of important questions relevant to employment, inequality, and policy. Who works in different types of self-employment? What resources facilitate some individuals obtaining higher quality self-employment arrangements? To what extent does the income from different types of arrangements keep people out of poverty? Are different types of arrangements associated with individuals being happier and having more job satisfaction? This work leverages novel restricted-access data collected in the HRS in 2016 on the employer names and locations for individuals reporting self-employment along with respondent narratives on industry and type of work to classify self-employment reports into three entrepreneurial roles (own/run; manage; independent) across 14 different types of work. Using the breadth of information collected in the HRS and linkage to administrative records, this work then presents differences in characteristics, such as demographics, income, wealth, savings, health insurance coverage, home ownership, health status, and expectations of working longer, associated with different classifications of self-employment. Exploring these questions provides unique insights into the changing nature of work and the transition to retirement relevant to policy considerations across the health, insurance, and retirement income dimensions, among others.

scholarly journals Examining gender differentials and determinants of private health insurance coverage in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
James Mulenga ◽  
Mulenga C. Mulenga ◽  
Katongo M. C. Musonda ◽  
Chilizani Phiri
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Agricultural Sector ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Probit Regression ◽  
Gender Differentials ◽  
And Gender ◽  
Professional Occupation

Abstract Background Health insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia. Methods The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses. Results The study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men. Conclusion The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.

scholarly journals Changes in Health Insurance Coverage Over Time by Immigration Status Among US Older Adults, 1992-2016

2020 ◽  
Vol 3 (3) ◽  
pp. e200731
Author(s):  
Jessica Cobian ◽  
Maynor G. González ◽  
Ying J. Cao ◽  
Huiwen Xu ◽  
Rui Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Immigration Status ◽  
Over Time

scholarly journals The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shaoguo Zhai ◽  
Shuiping Yuan ◽  
Quanfang Dong
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Health Expenditure ◽  
Financial Burden ◽  
Catastrophic Health Expenditure ◽  
Western China ◽  
Cooperative Medical Scheme ◽  
The Impact ◽  
The Relationship ◽  
Rural Older Adults

Abstract Background Older adults are more prone to various diseases. Health insurance becomes effective mechanism to relieve financial burden when the insured is sick. In China, most older adults live in the countryside, and New Rural Cooperative Medical Scheme is a kind of health insurance system in rural areas. The relationship between New Rural Cooperative Medical Scheme and financial burden due to health expenditure of older adults in China was investigated. This paper aims at the impact of New Rural Cooperative Medical Scheme on the poverty among rural older adults. Methods This study employs Probit model and Tobit model to assess the impact of New Rural Cooperative Medical Scheme on alleviating poverty among rural older adults based on a survey in nine representative counties in western China. Results The findings show that diseases have significantly negative impact on rural elderly poverty. New Rural Cooperative Medical Scheme has impact on alleviating of the health-payment poverty due to catastrophic health expenditure, but the impact is limited. The impact of health insurance on poverty alleviation is greater for men, older adults aged between 60 to 69 and households in in economically poorer area than their counterparts. Conclusions This study show the relationship between New Rural Cooperative Medical Scheme and catastrophic health expenditure of older adults in China. The results draw policy attention to introduce different reimbursement expense ratios for different groups to alleviate them from poverty based on more comprehensive insurance packages.

scholarly journals Identifying the determinants of health insurance coverage among Peruvian women of reproductive age: an assessment based on the national Peruvian demographic survey of 2017

2020 ◽  
Author(s):  
Eduardo Ramos Rosas ◽  
Volker Winkler ◽  
Stephan Brenner ◽  
Manuela De Allegri
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Multinomial Logistic Regression ◽  
Insurance Coverage ◽  
Universal Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Coverage Rates

Abstract Background: Like many other Latin America- and Caribbean countries, Peru has introduced a tax-financed health insurance scheme called “Sistema Integral de Salud (SIS)” to foster progress towards Universal Health Coverage. The scheme explicitly targets the poorest sections of the population. Our study explores levels of health insurance coverage and their determinants among Peruvian women following the introduction of SIS. We wish to determine the extent to which the introduction of SIS has effectively closed gaps in insurance coverage and for whom. Methods: Relying on the 2017 round of ENDES (Encuesta Nacional Demográfica y de Salud Familiar) survey, we analyzed data for 33168 women aged 15-49. We used multinomial logistic regression to explore the association between health insurance coverage (defined as No Insurance, SIS, Standard Insurance) and women’s socio-demographic and economic characteristics. Results: Out of the 33168 women, 25.3% did not have any insurance coverage, 45.5% were covered by SIS and 29.2% were covered by a Standard Insurance scheme. Women in the SIS group were found to have lower educational levels, live in rural areas and more likely to be poorer. Women in the Standard insurance group were found to be more educated, more likely to be “Spanish”, and to be wealthier. Most uninsured women appeared to belong to a middle class, not poor enough to be eligible for SIS, but also not eligible for standard insurance. Conclusions: Our study confirms that SIS has been effective in increasing coverage among vulnerable women, with coverage rates comparable with those observed among men. Nevertheless, on its own, it has proven to be insufficient to ensure universal coverage among women. Further reforms are needed to ensure that coverage is extended to all population groups.

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